implant crown came off...what to do?

[skipaheartbeat]

Hi. I have several implants fitted due to congenital hypodontia. These range from 10 years to 2 years old. The crown from a 10 year old implant has just unscrewed it's self from a back molar. The implant itself feels fine. Also the crown and screw both look undamaged. However I'm concerned with it being the weekend and being unable to get my dentist, that the gum will close up over the implant entry at gum level. Can anyone advise or reassure this is ok for a few days? Thanks in advance.

 

[Zuri Barniv]

If the gums heal over the implant for a few days it is totally not a big deal. Worst case scenario you would need to be numbed a little and it would be re-exposed so the crown can be put back on. My experience has been that if you put the crown back on, you really need to thoroughly recheck the bite. Usually a loose screw indicates excessive loads on the crown in relation to other teeth. Also, it would be STRONGLY advised NOT to reuse the same screw when putting it back on. Most screws from 10 yrs ago were made from gold or a gold alloy. When they get screwed in the first time, the screw deforms and it is permanently changed. If you reuse it, the likelihood of it loosening again are higher. Hope that helps.

 

[skipaheartbeat]

Much much appreciated it's been worrying me! I can totally cope with the gum being reopened if required. It was recently changed (the crown and screw) so I'm fairly sure it is a new type of screw. I have bruxism on top of all the other issues so my bite is an issue. I have a splint to help with this. My gut feeling is the screw wasn't adequately torqued on last appointment as my dentist had to leave for a lecture and left it in the hands of his senior house officer. (It's a UK dental hospital ). Many thanks again

 

[Zuri Barniv]

Don't know what a senior house officer is, but you've been dealing with this long enough to know what's what. Newer screws are usually made of titanium and can be rescrewed a couple of times. Still, insist they double check your bite when they do it. The most important thing to check is that when you grind your teeth from side-to-side there is absolutely zero contact on the implant crown with any other teeth. Hits from the side tend to loosen screws. Implants are most robust when receiving vertical pressures only.

 

[skipaheartbeat]

Brill thank you. My dentist is usually really good at checking my bite...He even sent me for hypnosis to try to counteract the bruxism. He's a great dentist and I am very lucky to have this treatment on our national health service (no cost to me). Senior house officer is just one level below consultant. Usually graduated approximately 5 to 6 years. I'm almost positive he said it was a titanium screw.